Alcohol Consumption and Multiple Dysplastic Lesions Increase Risk of Squamous Cell Carcinoma in the Esophagus, Head, and Neck

Chikatoshi Katada, Tetsuji Yokoyama, Tomonori Yano, Kazuhiro Kaneko, Ichiro Oda, Yuichi Shimizu, Hisashi Doyama, Tomoyuki Koike, Kohei Takizawa, Motohiro Hirao, Hiroyuki Okada, Takako Yoshii, Kazuo Konishi, Takenori Yamanouchi, Takashi Tsuda, Tai Omori, Nozomu Kobayashi, Tadakazu Shimoda, Atsushi Ochiai, Yusuke Amanuma & 5 others Shinya Ohashi, Tomonari Matsuda, Hideki Ishikawa, Akira Yokoyama, Manabu Muto

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background & Aims Some patients develop multiple squamous cell carcinomas (SCCs) in the upper aerodigestive tract, attributed to field cancerization; alcohol consumption has been associated with this process. We examined the association between multiple areas of dysplastic squamous epithelium with the development of SCC of the esophagus or head and neck cancer, as well as alcohol consumption and smoking. Methods We examined 331 patients with early stage esophageal SCC using Lugol chromoendoscopy to evaluate the dysplastic squamous epithelium in the esophagus. Patients then were assigned to 3 groups, based on the number of Lugol-voiding lesions: A, no lesion; B, 1–9 lesions; or C, 10 or more lesions. Participants completed lifestyle surveys on their history of drinking, smoking, and diet. All participants were evaluated by laryngopharyngoscopy before registration; only those without head and neck cancer were included, except for patients with superficial SCC limited to the subepithelial layer. Lesions detected in the esophagus and head and neck by surveillance were considered to be metachronous. The study end point was the cumulative incidence of metachronous SCCs in the esophagus and head and neck after endoscopic resection of esophageal SCC, according to the grade of Lugol-voiding lesions. At study entry, all patients were instructed to abstain from alcohol and smoking. Results Over the 2-year study period, metachronous SCCs of the esophagus were detected in 4% of patients in group A, in 9.4% of patients in group B, and in 24.7% of patients in group C (P <.0001 for patients in group A vs B or B vs C). Head and neck SCCs were detected in none of the patients in group A, in 1.7% of the patients in group B, and in 8.6% of the patients in group C (P =.016 for patients in group A vs C and P =.008 for patients in group B vs C). SCC of the esophagus or head and neck developed in 4.0% of patients in group A, in 10.0% of patients in group B, and in 31.4% of patients in group C (P <.0001 for group A vs B or A vs C). Alcohol abstinence decreased the risk of multiple SCCs of the esophagus (adjusted hazard ratio, 0.47, 95% confidence interval, 0.25–0.91; P =.025), whereas smoking abstinence did not. Conclusions Multiple dysplastic lesions in the esophagus increase the risk of multiple SCCs. Alcohol abstinence reduces the risk of metachronous SCCs. Clinical Trials registry: UMIN000001676 and UMIN000005466.

Original languageEnglish
Pages (from-to)860-869.e7
JournalGastroenterology
Volume151
Issue number5
DOIs
Publication statusPublished - Nov 1 2016

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Alcohol Drinking
Esophagus
Squamous Cell Carcinoma
Neck
Head
Smoking
Alcohol Abstinence
Head and Neck Neoplasms
Epithelium
Drinking
Registries
Life Style

Keywords

  • Carcinogenesis
  • Drinking Alcohol
  • Genetics Methods
  • Risk Factor

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Alcohol Consumption and Multiple Dysplastic Lesions Increase Risk of Squamous Cell Carcinoma in the Esophagus, Head, and Neck. / Katada, Chikatoshi; Yokoyama, Tetsuji; Yano, Tomonori; Kaneko, Kazuhiro; Oda, Ichiro; Shimizu, Yuichi; Doyama, Hisashi; Koike, Tomoyuki; Takizawa, Kohei; Hirao, Motohiro; Okada, Hiroyuki; Yoshii, Takako; Konishi, Kazuo; Yamanouchi, Takenori; Tsuda, Takashi; Omori, Tai; Kobayashi, Nozomu; Shimoda, Tadakazu; Ochiai, Atsushi; Amanuma, Yusuke; Ohashi, Shinya; Matsuda, Tomonari; Ishikawa, Hideki; Yokoyama, Akira; Muto, Manabu.

In: Gastroenterology, Vol. 151, No. 5, 01.11.2016, p. 860-869.e7.

Research output: Contribution to journalArticle

Katada, C, Yokoyama, T, Yano, T, Kaneko, K, Oda, I, Shimizu, Y, Doyama, H, Koike, T, Takizawa, K, Hirao, M, Okada, H, Yoshii, T, Konishi, K, Yamanouchi, T, Tsuda, T, Omori, T, Kobayashi, N, Shimoda, T, Ochiai, A, Amanuma, Y, Ohashi, S, Matsuda, T, Ishikawa, H, Yokoyama, A & Muto, M 2016, 'Alcohol Consumption and Multiple Dysplastic Lesions Increase Risk of Squamous Cell Carcinoma in the Esophagus, Head, and Neck', Gastroenterology, vol. 151, no. 5, pp. 860-869.e7. https://doi.org/10.1053/j.gastro.2016.07.040
Katada, Chikatoshi ; Yokoyama, Tetsuji ; Yano, Tomonori ; Kaneko, Kazuhiro ; Oda, Ichiro ; Shimizu, Yuichi ; Doyama, Hisashi ; Koike, Tomoyuki ; Takizawa, Kohei ; Hirao, Motohiro ; Okada, Hiroyuki ; Yoshii, Takako ; Konishi, Kazuo ; Yamanouchi, Takenori ; Tsuda, Takashi ; Omori, Tai ; Kobayashi, Nozomu ; Shimoda, Tadakazu ; Ochiai, Atsushi ; Amanuma, Yusuke ; Ohashi, Shinya ; Matsuda, Tomonari ; Ishikawa, Hideki ; Yokoyama, Akira ; Muto, Manabu. / Alcohol Consumption and Multiple Dysplastic Lesions Increase Risk of Squamous Cell Carcinoma in the Esophagus, Head, and Neck. In: Gastroenterology. 2016 ; Vol. 151, No. 5. pp. 860-869.e7.
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abstract = "Background & Aims Some patients develop multiple squamous cell carcinomas (SCCs) in the upper aerodigestive tract, attributed to field cancerization; alcohol consumption has been associated with this process. We examined the association between multiple areas of dysplastic squamous epithelium with the development of SCC of the esophagus or head and neck cancer, as well as alcohol consumption and smoking. Methods We examined 331 patients with early stage esophageal SCC using Lugol chromoendoscopy to evaluate the dysplastic squamous epithelium in the esophagus. Patients then were assigned to 3 groups, based on the number of Lugol-voiding lesions: A, no lesion; B, 1–9 lesions; or C, 10 or more lesions. Participants completed lifestyle surveys on their history of drinking, smoking, and diet. All participants were evaluated by laryngopharyngoscopy before registration; only those without head and neck cancer were included, except for patients with superficial SCC limited to the subepithelial layer. Lesions detected in the esophagus and head and neck by surveillance were considered to be metachronous. The study end point was the cumulative incidence of metachronous SCCs in the esophagus and head and neck after endoscopic resection of esophageal SCC, according to the grade of Lugol-voiding lesions. At study entry, all patients were instructed to abstain from alcohol and smoking. Results Over the 2-year study period, metachronous SCCs of the esophagus were detected in 4{\%} of patients in group A, in 9.4{\%} of patients in group B, and in 24.7{\%} of patients in group C (P <.0001 for patients in group A vs B or B vs C). Head and neck SCCs were detected in none of the patients in group A, in 1.7{\%} of the patients in group B, and in 8.6{\%} of the patients in group C (P =.016 for patients in group A vs C and P =.008 for patients in group B vs C). SCC of the esophagus or head and neck developed in 4.0{\%} of patients in group A, in 10.0{\%} of patients in group B, and in 31.4{\%} of patients in group C (P <.0001 for group A vs B or A vs C). Alcohol abstinence decreased the risk of multiple SCCs of the esophagus (adjusted hazard ratio, 0.47, 95{\%} confidence interval, 0.25–0.91; P =.025), whereas smoking abstinence did not. Conclusions Multiple dysplastic lesions in the esophagus increase the risk of multiple SCCs. Alcohol abstinence reduces the risk of metachronous SCCs. Clinical Trials registry: UMIN000001676 and UMIN000005466.",
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TY - JOUR

T1 - Alcohol Consumption and Multiple Dysplastic Lesions Increase Risk of Squamous Cell Carcinoma in the Esophagus, Head, and Neck

AU - Katada, Chikatoshi

AU - Yokoyama, Tetsuji

AU - Yano, Tomonori

AU - Kaneko, Kazuhiro

AU - Oda, Ichiro

AU - Shimizu, Yuichi

AU - Doyama, Hisashi

AU - Koike, Tomoyuki

AU - Takizawa, Kohei

AU - Hirao, Motohiro

AU - Okada, Hiroyuki

AU - Yoshii, Takako

AU - Konishi, Kazuo

AU - Yamanouchi, Takenori

AU - Tsuda, Takashi

AU - Omori, Tai

AU - Kobayashi, Nozomu

AU - Shimoda, Tadakazu

AU - Ochiai, Atsushi

AU - Amanuma, Yusuke

AU - Ohashi, Shinya

AU - Matsuda, Tomonari

AU - Ishikawa, Hideki

AU - Yokoyama, Akira

AU - Muto, Manabu

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Background & Aims Some patients develop multiple squamous cell carcinomas (SCCs) in the upper aerodigestive tract, attributed to field cancerization; alcohol consumption has been associated with this process. We examined the association between multiple areas of dysplastic squamous epithelium with the development of SCC of the esophagus or head and neck cancer, as well as alcohol consumption and smoking. Methods We examined 331 patients with early stage esophageal SCC using Lugol chromoendoscopy to evaluate the dysplastic squamous epithelium in the esophagus. Patients then were assigned to 3 groups, based on the number of Lugol-voiding lesions: A, no lesion; B, 1–9 lesions; or C, 10 or more lesions. Participants completed lifestyle surveys on their history of drinking, smoking, and diet. All participants were evaluated by laryngopharyngoscopy before registration; only those without head and neck cancer were included, except for patients with superficial SCC limited to the subepithelial layer. Lesions detected in the esophagus and head and neck by surveillance were considered to be metachronous. The study end point was the cumulative incidence of metachronous SCCs in the esophagus and head and neck after endoscopic resection of esophageal SCC, according to the grade of Lugol-voiding lesions. At study entry, all patients were instructed to abstain from alcohol and smoking. Results Over the 2-year study period, metachronous SCCs of the esophagus were detected in 4% of patients in group A, in 9.4% of patients in group B, and in 24.7% of patients in group C (P <.0001 for patients in group A vs B or B vs C). Head and neck SCCs were detected in none of the patients in group A, in 1.7% of the patients in group B, and in 8.6% of the patients in group C (P =.016 for patients in group A vs C and P =.008 for patients in group B vs C). SCC of the esophagus or head and neck developed in 4.0% of patients in group A, in 10.0% of patients in group B, and in 31.4% of patients in group C (P <.0001 for group A vs B or A vs C). Alcohol abstinence decreased the risk of multiple SCCs of the esophagus (adjusted hazard ratio, 0.47, 95% confidence interval, 0.25–0.91; P =.025), whereas smoking abstinence did not. Conclusions Multiple dysplastic lesions in the esophagus increase the risk of multiple SCCs. Alcohol abstinence reduces the risk of metachronous SCCs. Clinical Trials registry: UMIN000001676 and UMIN000005466.

AB - Background & Aims Some patients develop multiple squamous cell carcinomas (SCCs) in the upper aerodigestive tract, attributed to field cancerization; alcohol consumption has been associated with this process. We examined the association between multiple areas of dysplastic squamous epithelium with the development of SCC of the esophagus or head and neck cancer, as well as alcohol consumption and smoking. Methods We examined 331 patients with early stage esophageal SCC using Lugol chromoendoscopy to evaluate the dysplastic squamous epithelium in the esophagus. Patients then were assigned to 3 groups, based on the number of Lugol-voiding lesions: A, no lesion; B, 1–9 lesions; or C, 10 or more lesions. Participants completed lifestyle surveys on their history of drinking, smoking, and diet. All participants were evaluated by laryngopharyngoscopy before registration; only those without head and neck cancer were included, except for patients with superficial SCC limited to the subepithelial layer. Lesions detected in the esophagus and head and neck by surveillance were considered to be metachronous. The study end point was the cumulative incidence of metachronous SCCs in the esophagus and head and neck after endoscopic resection of esophageal SCC, according to the grade of Lugol-voiding lesions. At study entry, all patients were instructed to abstain from alcohol and smoking. Results Over the 2-year study period, metachronous SCCs of the esophagus were detected in 4% of patients in group A, in 9.4% of patients in group B, and in 24.7% of patients in group C (P <.0001 for patients in group A vs B or B vs C). Head and neck SCCs were detected in none of the patients in group A, in 1.7% of the patients in group B, and in 8.6% of the patients in group C (P =.016 for patients in group A vs C and P =.008 for patients in group B vs C). SCC of the esophagus or head and neck developed in 4.0% of patients in group A, in 10.0% of patients in group B, and in 31.4% of patients in group C (P <.0001 for group A vs B or A vs C). Alcohol abstinence decreased the risk of multiple SCCs of the esophagus (adjusted hazard ratio, 0.47, 95% confidence interval, 0.25–0.91; P =.025), whereas smoking abstinence did not. Conclusions Multiple dysplastic lesions in the esophagus increase the risk of multiple SCCs. Alcohol abstinence reduces the risk of metachronous SCCs. Clinical Trials registry: UMIN000001676 and UMIN000005466.

KW - Carcinogenesis

KW - Drinking Alcohol

KW - Genetics Methods

KW - Risk Factor

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